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Article History

Received: 30 April 2026

Accepted: 15 July 2026

First Online: 5 August 2026

Declarations

Conflict of interest: Virginia Bellido has served as a consultant/advisor for Abbott Diabetes Care, Dexcom, Eli Lilly, Novo Nordisk, and Sanofi; as a speaker for Abbott Diabetes Care, AstraZeneca, Boehringer Ingelheim, Eli Lilly, Merck, Novo Nordisk, and Sanofi; and has participated in research activities for Novo Nordisk, Eli Lilly, and Sanofi. Ana Cebrián declares funding to conduct clinical trials from MSD and Sanofi (all to the IMIB institute); consulting fees from AstraZeneca, Bayer, Eli Lilly, MSD, Novo Nordisk, and Sanofi; and payment of honoraria for lectures from AstraZeneca, Bayer, Boehringer Ingelheim, Eli Lilly, Menarini, MSD, Sanofi, and Novo Nordisk. Cristóbal Morales has participated in clinical trials for Novo Nordisk, Sanofi, AstraZeneca, Pfizer, Eli Lilly, Merck, Lexicon, Hanmi, Janssen, Boehringer, Takeda, Roche, and Theracos; has served on advisory boards for Novo Nordisk, Eli Lilly, MSD, Boehringer, AstraZeneca, Sanofi, and Abbott; and has received speaker fees from Sanofi, Novo Nordisk, AstraZeneca, Roche, Eli Lilly, Boehringer, MSD, Ferrer, Janssen, and Abbott. Alberto S. de las Hazas has received consulting fees from Sanofi and reports speaker fees from Novo Nordisk, GSK, Abbott, Bial, Teva, Pfizer, and Esteve. Alfonso Soto-Gonzalez has received consulting fees from Novo Nordisk, Eli Lilly, and Bayer, and reports speaker fees from Novo Nordisk, Sanofi-Aventis, Eli Lilly, Bayer, Novartis, Menarini, and Boehringer, as well as research support from Novo Nordisk, MSD, Eli Lilly, Bayer, Boehringer, and Novartis. Carla Morer-Liñan has received consulting fees from Eli Lilly; speaker fees from Eli Lilly, Novo Nordisk, AstraZeneca, and Servier; and research support from Sanofi. José M. Borrachero has received consulting and speaker fees from Dexcom, Abbott, Novo Nordisk, Eli Lilly, Ascensia, Sanofi, and Air Liquide. Gabriel Cuatrecases has received consulting fees from Eli Lilly, Abbott, and Roche; speaker fees from Eli Lilly and Novo Nordisk; and research support from Sanofi. Silvia Lozano-García reports speaker fees from Sanofi, AstraZeneca, Novo Nordisk, Eli Lilly, and Boehringer Ingelheim. Álvaro M. Bayón has received consulting fees from GSK, Pfizer, and MSD; speaker fees from Pfizer, Sanofi Pasteur, GSK, Lundbeck, AstraZeneca, Novartis, Grünenthal, Novo Nordisk, Esteve, Eli Lilly, and Organon; and research support from Sanofi and GSK. Cristina M. Niño-Azcarate reports speaker fees from Novo Nordisk, Sanofi, and AstraZeneca; and research support from Sanofi. Oscar Laclaustra and Paulina Fuentealba are employees of Sanofi Spain. Elena L. García and Judith López-Fernández have no conflicts of interest to declare.

Ethical Approval: The study was carried out in accordance with the Declaration of Helsinki and Good Clinical Practice Guidelines and applicable regulatory requirements. The study protocol was approved by the Seville Provincial Drug Research Ethics Committee (CEIm code: 2541-N-21). Written informed consent was obtained from all participants before enrollment.